Homestead_Zickefoose INDIANA SALES DISCLOSURE FORM SDF ID: 2016 Page 2
D. PREPARER
Teresa S. Holifield Escrow Officer
Preparerof the Sales Disclosure Form Title
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
Address(Number and Street) Company
Evansville, Indiana 47713 (812)425-0055 teresa@swinland.com
City,State,and ZIP Code Telephone Number E-mail
E. SELLER(S)/GRANTOR(S)
Nathan W. Snipes Emily F. Snipes
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
9859 S.Joy Lane 9859 S. Joy Lane
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 Haubstadt, IN 47639
Under penalties of perju , I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true,correct
an complete as requ ed b •repared in accordance with IC 6-1.1- .5, "Real Property Sales Disclosure Act".
a • api
Signature of Seller • Signature of Selle
Nathan W. Snipes 6/29/2016 Emily F. Snipes 6/29/2016
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller �r •ate(MM/DD/YYYY)
F. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS -IDENTIFY A TIM TH P')
aniel A. Zickefoose I Annessa N. Zickefoose
buyer I- ame as appears on conveyance document Buyer 2-Name as appears on conyyy1anc docis1
ID
2110 Ashton Ct.Apt 2 2110 Ashton Ct.Apt 2 JUL .7 LU
Address(Number and Street) Address(Number and Street) n
Princeton, IN 47670 Princeton, IN 47670M1I
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES 6NBFHoN�
0 ❑ 1. Will this property be the buyer's primary 0 ❑ 3. Homestead
residence? Provide complete address of primary ❑ 0 4. Solar Energy Heating/Cooling System
residence, including county:
❑ 0 5. Wind Power Device
9859 S Joy Lane ❑ 0 6. Hydroelectric Power Device
Address(Number and Street)
iHaubstadt, IN 47639 I Gibson ❑ 0 7. Geothermal Energy Heating/Cooling Device
City, State ZIP Code County ❑ 0 8. Is this property a residential rental property?
❑ X 2. Does the buyer have a homestead in Indiana to be ❑ 0 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete property via-email? (Provide contact information
address of residence being vacated, including county: below Please see instructions for more information.
Address(Number and Street)
AA• 13-35 - oo - ood . /io - OA
City,State ZIP Code County Primary property owner contact name E-m.it